METHODS: We conducted a population-based, trend analysis of U.S. psychiatric hospitalizations and calculated quarterly (Q) rates per 100,000 population of substance-involved psychiatric hospitalizations. We assessed U.S. regional quarterly percentage hospitalization rate changes using Joinpoint regression.
RESULTS: From Q4 2015-Q4 2019, there were 963,202 psychiatric hospitalizations, 50,223 (5.2 %) involved methamphetamine and 102,877 (10.7 %) involved opioids and/or cocaine without methamphetamine. Methamphetamine-involved psychiatric hospitalization rates increased by 68.0 %, psychiatric hospitalizations rates involving opioid and/or cocaine without methamphetamine decreased by 22 %, while nonsubstance-involved psychiatric hospitalizations rates remained unchanged. The largest significant increases in methamphetamine-involved psychiatric hospitalization rates were among people >61 years old, males, and Midwesterners. Methamphetamine-involved psychiatric hospitalization rates doubled among Black patients. The largest average percent increase among methamphetamine-involved psychiatric hospitalizations was 10.2 % from Q4 2015-Q2 2017 in the Midwest.
CONCLUSIONS: Most psychiatric hospitalizations did not involve substances. Methamphetamine-involved psychiatric hospitalizations greatly increased while opioid-involved psychiatric hospitalizations decreased, but involved more total encounters. Greater access to harm reduction services, contingency management programs, and mental health services is urgently needed.
方法:我们以人群为基础,美国精神病住院率的趋势分析,并计算出每100,000名涉及物质的精神病住院患者的季度(Q)率.我们使用Joinpoint回归评估了美国地区季度住院率百分比变化。
结果:从2015年第四季度到2019年第四季度,有963,202例精神病住院,50,223(5.2%)涉及甲基苯丙胺,102,877(10.7%)涉及阿片类药物和/或可卡因,不含甲基苯丙胺。涉及甲基苯丙胺的精神病住院率增加了68.0%,涉及阿片类药物和/或可卡因而不含甲基苯丙胺的精神病住院率下降了22%,而非物质相关的精神病住院率保持不变。与甲基苯丙胺有关的精神病住院率的最大显着增加是在61岁以上的人群中,男性,和中西部人。在黑人患者中,涉及甲基苯丙胺的精神病住院率翻了一番。在中西部地区,与甲基苯丙胺有关的精神病住院治疗的平均增幅最大,为2015年第四季度至2017年第二季度的10.2%。
结论:大多数精神病住院不涉及药物。涉及甲基苯丙胺的精神病住院治疗大大增加,而涉及阿片类药物的精神病住院治疗减少,但涉及更多的接触。获得更多减少伤害服务的机会,应急管理计划,迫切需要精神卫生服务。